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Medico-legal aspects of abortion in Europe : 

Medico-legal aspects of abortion in Europe Bojana Pinter University Dept. Of Ob/Gyn Ljubljana, Slovenia Why are teenagers still getting pregnant? 6th Seminar, ESC, 8 Oct. 2001, Coimbra

Pregnancies in the world: 

Pregnancies in the world 210 million women get pregnant annually 15% miscarriages, stillbirths 22% induced abortions 63% live births

Abortion – a response to unwanted pregnancy: 

Abortion – a response to unwanted pregnancy 50 million abortions occur annually 20 million abortions are unsafe, usually illegal every day more than 200 women die of unsafe abortion

Abortion in Europe: 

Abortion in Europe culture economic status religion law Aspects of abortion laws rates practices

ABORTION LAWS IN EUROPE: 

ABORTION LAWS IN EUROPE Abortion: completely prohibited to save woman’s life, protect her physical health … to protect woman’s mental health … on socioeconomic grounds … on demand

Completely prohibited: 

Completely prohibited Ireland Malta

To save woman’s life, to protect her physical health: 

To save woman’s life, to protect her physical health Poland (R, I, F)

… to protect woman’s mental health: 

… to protect woman’s mental health Northern Ireland Portugal (R,F) Spain (R,F) Switzerland

… on socioeconomic grounds: 

… on socioeconomic grounds Finland Great Britain Hungary

… on demand: 

… on demand Albania Austria Belarus Bosna-Hercegovina Belgium Bulgaria Croatia Czech Republic Denmark Estonia France Germany Greece Italy Latvia Lithuania Macedonia Moldova Netherlands Norway Romania Russia Slovak Republic Slovenia Sweden Ukraine Turkey Yugoslavia

Gestational limits: 

Gestational limits 10 weeks: Slovenia, Turkey 12 weeks: others 14 weeks: Belgium 22 weeks: Netherlands

Consent: 

Consent parental consent Austria, Czech Republic, Denmark, Germany, Greece, Hungary, Italy, Netherlands, Norway, Russia, Sweden, Turkey partner consent Turkey

Counselling and waiting period: 

Counselling and waiting period counselling: Albania, Belgium, France, Germany, Hungary, Netherlands, Poland, Russia, Spain, Turkey waiting period: 3 – 8 days: Belgium, France, Germany, Hungary, Netherlands, Poland

Accessability: 

Accessability facilities: governmental, private practitioner: Ob/Gyn spec., GPs abortion charged: Czech Republic, Hungary, Latvia, Russia, Turkey accessability?: Austria, Germany, Spain, Portugal

Data on illegal abortion: 

Data on illegal abortion Poland? Northern Ireland? Portugal? Russia?

ABORTION RATES IN EUROPE: 

ABORTION RATES IN EUROPE Western Europe Netherlands: 6.5/1000 women 15-44 yrs abortion ratio: 10.6 total ab. rate: 0.2 Eastern Europe Romania: 78/1000 women 15-44 yrs abortion ratio: 63.0 total ab. rate: 2.3

Abortion rates in Western Europe (abortions/1,000 women 15-44 yrs) Source: The Alan Guttmacher Institute. Sharing responsibility. Women society and abortion worldwide. New York: The Alan Guttmacher Institute, 1999: 54.: 

Abortion rates in Western Europe (abortions/1,000 women 15-44 yrs) Source: The Alan Guttmacher Institute. Sharing responsibility. Women society and abortion worldwide. New York: The Alan Guttmacher Institute, 1999: 54.

Abortion rates in Eastern Europe (abortions/1,000 women 15-44 yrs) Source: The Alan Guttmacher Institute. Sharing responsibility. Women society and abortion worldwide. New York: The Alan Guttmacher Institute, 1999: 54.: 

Abortion rates in Eastern Europe (abortions/1,000 women 15-44 yrs) Source: The Alan Guttmacher Institute. Sharing responsibility. Women society and abortion worldwide. New York: The Alan Guttmacher Institute, 1999: 54.

ABORTION PRACTICES: 

ABORTION PRACTICES Safe abortion early in pregnancy by well-trained practitioner using surgical or medical method in legal setting

First trimester abortion: 

First trimester abortion vacuum aspiration dilatation and curretage medical abortion mifepristone & prostaglandins methotrexate & prostaglandins

The history of vacuum aspiration: 

The history of vacuum aspiration 1863: Simpson (Scotland) 1927: Bykov (Russia) 1958: Tsai, Wu, Wu (China) 1961: Zubejev (Russia) 1964: Novak (Slovenia) 1968: Novak - transfer to the West

Medical abortion (mifepristone & PG): 

Medical abortion (mifepristone & PG) 1992: France 49 days: 600 mg mifepristone + 400 g misoprostol 200 mg mifepristone + 800 g misoprostol 63 days: 600 mg mifepristone + 1 mg gemeprost 200 mg mifepristone + 800 g misoprostol

Availability of medical abortion: 

Availability of medical abortion Available Austria Belgium Denmark France Germany Israel Netherlands Russia Slovenia Spain Sweden Switzerland United Kingdom Not available Czech Republic Greece Hungary Ireland Italy Poland Portugal Turkey

Second trimester abortion: 

Second trimester abortion medical induction with prostaglandins dilatation and evacuation intrauterine instillation of prostaglandins, hypertonic saline

CONCLUSION: 

CONCLUSION good family planning service appropriate legislation of abortion law and practice are the essential conditions to reduce the need for abortion to prevent unsafe abortion

Acknowledgments: 

Acknowledgments Ann Verougstraete Sven Skouby George Creatsas David Cibula Gyoergy Bartfai Mary Short Melanija Orlean Jany Rademakers Rob Beerthuizen Medard Lech Irina Savelieva Vera Prilevskaia Carme Coll Sinan Ozalp Ann Webb